Editorial: Wanted: more focus on drug addiction

It’s easy to understand why Jim Weinstein, the head of the Dartmouth-Hitchcock health system, is frustrated. When it comes to health care, much of what he hears from politicians at the State House is merely a discussion of money: Should the state accept federal Medicaid expansion money or reject it? Should the state finagle more Medicaid money from the feds or tax the hospitals more?

In an interview with Monitor editors this week, Weinstein said he’s looking for state leaders to focus on the bigger picture: What’s the goal? What are we hoping to achieve with all this wrangling? And among his biggest priorities for the state is one with which it’s hard to argue: more sustained attention to solving the public health crisis of alcohol and drug abuse.

Drugs have been in the news lately because of the deaths of two New Hampshire students attributed to overdoses of MDMA. But for the most part, drug and alcohol abuse by teens and adults alike remains a cause that few political leaders embrace, despite the real damage done to lives and communities.

This is particularly, vexingly, true in New Hampshire.

Reported drug abuse or dependence among New Hampshire residents is 11 percent, compared to the national average of 9.22 percent, according to the New Futures organization, which is dedicated to reducing alcohol and drug problems in the state. And New Hampshire’s underage alcohol and other drug problems are among the highest in the country. The organization calculates the annual cost of underage alcohol consumption at $180 million, which takes into account violence, traffic crashes, high-risk sex, property crime, unintentional injuries, poisoning, fetal alcohol syndrome and treatment.

However you do the math, the effects are clearly far-reaching.

In the face of the problem, New Hampshire’s 424 legislators have, predictably, moved in contradictory directions in recent years.

On one hand, the state recently became the 49th to create a secure electronic system to monitor the prescribing and dispensing of controlled prescription drugs. On the other hand, funding for the Governor’s Commission on Alcohol and Drug Abuse Prevention has been dramatically reduced in recent year. And this year lawmakers quickly rejected a plan to raise the beer tax from 30 cents per gallon (where it’s been since 1983) to 40; the increased revenue would have gone to the state fund for alcohol abuse prevention and treatment.

Expanding Medicaid coverage to more New Hampshire residents might actually be among the most important efforts to combat substance abuse that legislators could make. If approved, it would add substance use disorder services as a benefit for Medicaid patients. So far, of course, lawmakers have delayed a decision on the expansion, with a final report by a study commission due Oct. 15.

Helping New Hampshire residents resist substance addiction and helping them find a better path when they stumble is not simply a job for hospital systems like Weinstein’s. As he notes, 30 percent of health issues are related to social issues. Gov. Maggie Hassan and the Legislature have done admirable work this year in beginning to undo years of neglect imposed on the state’s mental health system, for instance, and its programs for incarcerated women. Substance abuse should also be on their list.